黄元御辨治温病学术特色

Huang Yuan-yu′s Academic Characteristics of Differentiation and Treatment of Warm Diseases

黄元御提出,温病与热病本质相同,病机为风邪伤人,木火与己土受邪,木火主血,随己土而升,而风邪伤卫,则内乘阴位而逼迫营血,热不能外达,而成温病。其认为,“内外感伤,百变不穷,溯委穷源,不过六气。”将六经气化理论运用于温病的治疗中。温病太阳证,卫气已闭,营郁初起,治宜开腠理,清营热,采用“凉金补水”之法,施以玄霜丹;阳明证为燥热不泄,胃腑积热,治疗应在腑热未动之时,清解阳明经之热,方用素雪丹;少阳证为相火内郁,治宜清凉和解,散其炎烈,用红雨丹;太阴证多见湿盛之象,太阴之湿夺于阳明之燥,治宜清散皮毛,滋太阴湿土并泻阳明燥金,用黄酥丹;少阴证能化寒为热,治宜清散皮毛,泻君火而益肾水,方用紫玉丹;厥阴证,火煎迫营阴,治宜清散皮毛,滋风木兼泻相火,方用苍霖丹。以六经统领温病,又不为其所拘泥,所用方药多法于仲景,却重视顾护脏阴,多用补阴泻阳之法。

Huang Yuan-yu points out that warm diseases and febrile diseases are essentially the same.The pathogenesis is that wind pathogen injures people.Wood fire and spleen earth are affected by pathogens.Wood fire dominates blood and rises with spleen earth.While wind pathogen injures defensive qi,it attacks yin internally and forces nutrient blood.When heat cannot reach outside,and warm disease occurs.He believes that "various internal and external contraction can trace the source to six qi ",and applies the theory of six meridians′ qi transformation to the treatment of warm diseases.In the case of warm disease with greater yang syndrome,the defensive qi has been closed,and the nutrient depression has begun to occur.It is appropriate to open up interstitial striae and clear the nutrient heat.The method of "cooling the metal and replenishing the water" is adopted,and Xuanshuang Elixir(玄霜丹,XSE) is applied.Yang brightness syndrome is characterized by dry heat without purgation,and heat accumulation in the stomach.The treatment should be carried out by clearing the heat of yang brightness meridian when the heat in the stomach has not moved,and then Suxue Elixir(素雪丹,SXE) can be used.Lesser yang syndrome is characterized by internal depression of minister fire.It should be treated with cooling and reconciliation to dispel its intense inflammation,so Hongyu Elixir(红雨丹,HYE) can be used.Greater yin syndrome is characterized by excessive dampness.The dampness of greater yin is captured by the dryness of yang brightness.It is advisable to clear and disperse the skin and body hair,nourish the damp earth of greater yin and purge the dry metal of yang brightness,so Huangsu Elixir(黄酥丹,HSE) can be used.Lesser yin syndrome can transform cold into heat.The treatment should clear and disperse the skin and body hair,purge sovereign fire and tonify kidney water,so Ziyu Elixir(紫玉丹,ZUE) can be used.For reverting yin syndrome,the fire will force nutrient yin.It is advisable to clear the skin and body hair,nourish the wind wood and purge the minister fire,so Canglin Elixir(苍霖丹,CLE) can be used.In a word,the theory of six meridians is used to guide warm diseases,but not constrained by it.Most of the formulas and medicines used follow the opinion of Zhang Zhong-jing,the theory pays attention to protecting the internal organs yin,and usually using the methods of tonifying yin and purging yang.